Pain management

If you haven’t tried physical therapy before, you may wonder how it could help relieve your chronic pain.

A physical therapist can show you how to perform exercises to will help ease chronic pain.

Physical therapy uses a variety of approaches to tackle pain/chronic pain and boost physical functioning, and is often recommended as part of pain management.

What Physical Therapy Offers
These are seven ways physical therapy can help with chronic pain:

1. Individualized treatment. Physical therapy is all about you. You and the therapist will go over the various aspects of your pain the first time you meet. If you’re anxious about some aspect of physical therapy, this is the time to bring it up. It’s also a great time to bring up any specific goals you have. Maybe you’d like to walk longer distances or ride your bike again, for instance. The more open you can be about problem areas and goals, the better. Once you’ve reviewed everything, the therapist will develop a program tailored specifically to your needs.

2. Safe moves. It’s natural to be cautious in your movement when you’re hurting, but physical activity is needed to decrease stiffness, ease pain, and enhance your overall functional ability. Having a physical therapist direct and monitor your movements will dispel your worries about injuring yourself, allowing you to safely push yourself beyond what you could do independently.

3. An opportunity to avoid surgery. Physical therapy is a nonsurgical treatment often recommended to patients before considering surgery. The combination of manual therapies, specific functional strengthening exercise, stretches, and modalities can often relieve pain and improve functional ability so well that surgery is avoided.

4. Hands-on pain relief. Manual therapy is often used in skilled physical therapy– it involves pressure applied to targeted areas of the body to improve tissue extensibility; increase range of motion, and mobilize soft tissue and joints in effort to reduce pain.

5. Strategies to ease pain. Physical therapists are often a good resource to help you understand physiological factors and neuroscience involved in your pain. They are also able to suggest some ergonomic tweaks to your workstation and/or explain how tobacco use or alcohol could make your pain worse.

6. Support and encouragement. Working closely with someone focused on relieving your pain can offer both a physical and mental boost. Chronic pain can be an isolating experience, and it’s nice to know you’re not alone.

7. Control over your pain. Knowing that there is a way to reduce and manage your pain on your own, without medicines or surgery, can give you a sense of control. That sense of control can ease the release of stress hormones, further reducing pain.

Physical therapy sessions generally run from about 20 minutes to an hour, and usually include more than one visit per week. Over time, most people learn exercises and stretches to perform independently at home, and formal physical therapy appointments are no longer needed.

Before a treatment or rehabilitation plan can be made, your orthopedist must first determine the reason for, and source of, your condition. This typically involves a complete physical exam and a review of your medical history profile, in addition to a description of your symptoms. Be sure to tell your healthcare providers of any other illnesses, injuries, or complaints that may be associated with the pain or condition. Also, tell him or her about any previous treatments or medicines prescribed. Initial tests may then follow.

Arthrogram. This X-ray shows bone structures after an injection of a contrast fluid into a joint area. When the fluid leaks into an area that it does not belong, disease or injury may be considered, as a leak would provide evidence of a tear, opening, or blockage.

Magnetic resonance imaging (MRI). This test uses large magnets, radiofrequencies, and a computer to make detailed images of organs and structures within the body. It can often determine damage or disease in a surrounding ligament or muscle.

Computed tomography scan (also called a CT or CAT scan). This test uses X-rays and computer technology to make horizontal, or axial, images (often called slices) of the body. A CT scan shows detailed images of any part of the body, including the bones, muscles, fat, and organs. CT scans are more detailed than general X-rays.

Electromyogram (EMG). This test evaluates nerve and muscle function.

Ultrasound. This test uses high-frequency sound waves to create an image of the internal organs

Arthroscopy. This test is used to evaluate a joint. It uses a small, lighted, optic tube (arthroscope) that is inserted into the joint through a small incision in the joint. Images of the inside of the joint are projected onto a screen. It’s used to evaluate any degenerative or arthritic changes in the joint. It also detects bone diseases and tumors and may help determine the cause of bone pain and inflammation.

Myelogram. This test involves the injection of a dye or contrast material into the spinal canal. Next a specific X-ray study lets the healthcare provider evaluation of the spinal canal and nerve roots.

Radionuclide bone scan. This is a nuclear imaging technique. It uses a very small amount of radioactive material, which is injected into the patient’s bloodstream to be detected by a scanner. This test shows blood flow to the bone and cell activity within the bone.

Blood tests. Other blood testsmay be used to check for certain types of arthritis.

After the evaluative information is collected and reviewed, the orthopedist will discuss the treatment options with you to help you select the best treatment plan that promotes an active and functional life.

Children – What are standard evaluation procedures?

Children will be treated much like the adults are with a full physical exam and a detailed medical history. At this time, be sure to tell your child’s doctor of any other illnesses, injuries, or complaints that have been associated with the pain or condition, as well as any previous treatments or medicines prescribed. Some early tests may then be done, including:

Advanced evaluation procedures

Children who need further evaluation may undergo 1 or more of the following:

Magnetic resonance imaging (MRI). A diagnostic procedure that uses a combination of large magnets, radiofrequencies, and a computer to produce detailed images of organs and structures within the body.

Computed tomography scan (also called a CT or CAT scan).A diagnostic imaging procedure that uses a combination of X-rays and computer technology to produce horizontal, or axial, images (often called slices) of the body. A CT scan shows detailed images of any part of the body, including the bones, muscles, fat, and organs. CT scans are more detailed than general X-rays.

EMG (electromyogram).A test used to evaluate nerve and muscle function.

Bone scan.A nuclear imaging method to evaluate any degenerative and/or arthritic changes in the joints; to detect bone diseases and tumors; to determine the cause of bone inflammation.

This is becoming a common test for evaluating musculoskeletal complaints.

After the evaluative information is collected and reviewed, your child’s orthopaedist will discuss with you all treatment options and help you select the best treatment plan to enable your child to live an active and functional life.

Blue Ridge Orthopaedic & Spine Center has two convenient office locations in Warrenton (540) 347.9220 & Gainesville (703) 743.2814 to serve all of your Orthopaedic needs. Call us today to schedule an appointment. Same day/next day appointments available. For more information on all comprehensive services we offer, visit www.broava.com.

Corticosteroid injections are powerful drugs used to decrease inflammation in the body’s tissues. Corticosteroid injections can treat a range of muscular, skeletal, and spinal conditions. This article from KRAMES STAYWELL shows us the most common uses of corticosteroid injections:

Lower back pain – Lower back pain from strains, spinal stenosis, ruptured disks, and other common conditions may be treated with injectable corticosteroids to provide some reprieve from pain. Lumbar radiculopathy is pain in the buttocks, hips, or legs that stems from a pinched nerve in the lower back. This kind of pain can usually be treated with corticosteroid injections near the pinched nerve. If a patient is having excruciating pain, the injection may target the spinal cord area through a catheter. Sometimes other drugs such as local anesthetics or narcotics are given in conjunction with the corticosteroid.

Osteoarthritis – Osteoarthritis suffers often develop inflammation and pain in their joints. An injection of corticosteroids into the affected joint can provide temporary pain relief for several weeks or even months. After the treatment, you will need to rest the joint for at least 24 hours for the best results.

Carpal tunnel syndrome – Carpal tunnel syndrome may occur when a nerve in the wrist becomes compressed or pinched, causing pain and weakness in the hand. Infecting a corticosteroid in the wrist can provide immediate relief.

Cervical radiculopathy – This is neck pain that radiates to the shoulder and arm. It occurs when the vertebrae in the spine moves closer together, pinching a nerve in the neck. Injecting corticosteroids near the pinched nerve may reduce pain and swelling allowing for time to heal .

Blue Ridge Orthopaedic & Spine Center has two convenient office locations in Warrenton (540) 347.9220 & Gainesville (703) 743.2814 to serve all of your Orthopaedic needs. Call us today to schedule an appointment. Same day/next day appointments are available. For more information on all comprehensive orthopaedic services we offer visit www.broava.com.

Blue Ridge Orthopaedic & Spine Center has two convenient office locations in Warrenton (540) 347.9220 & Gainesville (703) 743.2814 to serve all of your Orthopaedic needs. Call us today to schedule an appointment. Same day/next day appointments available. For more information on all comprehensive services we offer visit www.broava.com.

For most people suffering from back pain, surgery is scheduled only after all other options have been exhausted.

One non-surgical approach to pain relief is epidural steroid injections. They are only intended for temporary pain relief, but steroid injections coupled with therapeutic exercise may allow patients to postpone or even avoid surgery altogether.

The most common reader complaints were centered on the side effects associated with steroids. Many reported significant weight gain and bloating, swelling of the face, feet and ankles, and headache and nausea.

Another concern for some readers, especially those with diabetes, was the rise in blood sugar associated with steroids.

Efficacy of epidural steroid injections

There is no conclusive evidence that epidural steroid injections work better for one condition than another. Success rates are different for each individual. For those hoping to postpone surgery, injections may provide enough temporary relief.

Steroid injections may also effect enough pain relief to allow you to begin a physical exercise program. Many people have gained enough pain relief through an exercise program to avoid surgery.

The most important thing is to find a doctor that you trust, and who will adequately answer any questions you may have regarding your condition or the injection procedure.

Blue Ridge Orthopaedic & Spine Center has on-site state-of-the-art technology to diagnosis and treat orthopaedic conditions. Both of our offices are equipped with in-office radiology departments. Not only does this facilitate rapid diagnosis but it is also convenient for patients who may be experiencing pain or disability at the time of their visit. To schedule an appointment with one of our board-certified and fellowship trained physicians, call our Warrenton office at 540-347-9220 or our Gainesville office at 703-743-2814.